Vaer Report Details
Age: NA
Gender: Male
State: Outside US
- Patient Died?
- No
- Vaccine information
-
Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Type: Coronavirus 2019 vaccine
Manufacturer: PFIZER
Lot: acb8491
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2022-01-20
- Date of Onset
- 5
- Number of days (onset date – vaccination date)
- 5
- Adverse Event Description
-
laboratory confirmed covid-19; laboratory confirmed covid-19; ra this is a non-interventional study report from the regulatory authority-web and product quality group. a 44 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 20jan2022 (lot number: acb8491) as dose 3 (booster), single, administration date 24aug2021 (lot number: fg6273) as dose 2, single and administration date 13jul2021 (lot number: ff0688) as dose 1, single for covid-19 immunisation. relevant medical history included: "alcoholism" (unknown if ongoing); "bilateral saphenectomy" (unknown if ongoing); "carotid thromboendarterectomy ", start date: 2021 (unknown if ongoing), notes: diagnosis in 2021; "hypertension arterial" (unknown if ongoing); "appendectomy" (unknown if ongoing). concomitant medications included: cardioaspirin; omeprazole; benerva; bisoprolol; atorvastatin; eskim. the following information was reported: covid-19 (medically significant), drug ineffective (medically significant) all with onset 25jan2022, outcome "unknown" and all described as "laboratory confirmed covid-19". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (25jan2022) positive, notes: swab. sender comment: the report came from the regulatory authority study. all the data in our possession have already been entered. the reporter's assessment of the causal relationship of the "laboratory confirmed covid-19" with the suspect product(s) bnt162b2 was not provided at the time of this report. since no determination has been received, the case is managed based on the company causality assessment. no follow-up attempts are possible. no further information is expected.; sender's comments: the efficacy of a drug varies from patient to patient and can be affected by different factors; however, a contributory role of the suspect product bnt162b2 to the reported drug ineffective / covid-19 cannot be ruled out.,linked report(s) : it-pfizer inc-202200307290 same patient/product, different dose/events
- Lab Data
-
test date: 20220125; test name: laboratory confirmed covid-19; test result: positive ; comments: swab
- List of symptoms
-
drug ineffective covid-19 sars-cov-2 test
- Patient Died?
- No
- Date Died
- NA
- Birth defect
- false
- Vaccine Administered By:
- Other
- Vaccine Purchased By:
- Unknown
- Patient visit ER?
- No
- Patient Hospitalized?
- No
- Stay in hospital
- No
- Days in hospital
- Unspecified
- Permanent disability?
- No
- Allergies:
-
na
- Current Illness
-
na